Clinical Guidelines FHIR IG Proposal

Recommendation of Clinical Practice Guideline Recommendations in FHIR

Owning work group name

Clinical Decision Support

Committee Approval Date:

PSS: 2019-01-15 IG Proposal: 2019-07-10 (https://confluence.hl7.org/display/CDS/2019-07-10+Meeting+Agenda)

Publishing Lead

Bryn Rhodes bryn@databaseconsultinggroup.com

Contributing or Reviewing Work Groups

• Clinical Quality Information (Co-Sponsor, approved 2019-01-16)
• Patient Care (Co-Sponsor, approved 2019-02-18)
• Public Health (Interested Party, contributing example content)

FHIR Development Project Insight ID

1505

Scope of coverage

This implementation guide is intended to support expression of computable clinical guidelines across clinical domains, and in any locale. Of particular interest is ensuring support for Low and Middle Income Countries (LMIC) to enable organizations like the CDC and WHO to produce computable versions of their paper guidelines.

Content location

http://github.org/HL7/cqf-recommendations

Proposed IG realm and code

uv/cpg

Maintenance Plan

Guideline developers participating in the project (such as CDC and WHO) are interested in developing content IGs that are based on this IG and so have an interest in maintaining it.

Short Description

This implementation guide is a multi-stakeholder effort to use FHIR resources to build shareable and computable representations of the content of clinical care guidelines. The guide focuses on common patterns in clinical guidelines, establishing profiles, conformance requirements, and guidance for the patient-independent, as well as analogous patterns for the patient-specific representation of guideline recommendations.

Long Description

The process of guideline implementation is a significant challenge that is currently complicated by the lack of computable guideline content. Health systems and vendors implement evidence-based guidance, but almost always independently, leading to signficant duplicate effort, as well as inconsistent implementation. This implementation guide will build on experience from multiple guideline representation projects to establish patterns and practices that support development and implementation of shareable computable guideline recommendations.

The specification combines experience gained from multiple guideline representation projects, including Opioid Prescribing Support, Chronic Kidney Disease Management, Antenatal Care, HIV/HBV Screening, Prevention, and Treatment, and Immunization Decision Support.

Involved parties

Centers for Disease Control World Health Organization IHE Quality Reporting and Public Health Workgroup (Coordinated with the CCG and DCP profiles)

Expected implementations

Allscripts OpenMRS/OpenSRP DHIS2

Content sources

Previous work on computable guideline representation presented to the AeHIN Opioid Prescribing Support implementation guide Quality Measure implementation guide Pilot work from the Clinical Quality Framework (including radiology, chlamydia screening, and zika virus)

Example Scenarios

CDC Opioid Prescribing Support Guideline WHO Antenatal Care Guideline Chronic Disease Management - Chronic Kidney Disease Hepatitis B Screening, Immunization, and Follow-up Immunization Recommendations

IG Relationships

This IG will provide profiles, guidance, and conformance requirements to enable "content" IGs such as the CDC Opioid Prescribing Guideline Implementation Guide.

This IG is also complementary to the Quality Measure IG, supporting the decision support aspects of quality improvement, while that IG focuses on the quality measurement aspects.

This IG will also be coordinated with the IHE Computable Care Guidelines (CCG) profile (which will focus on testability of computable guideline content) and the Dynamic Care Planning (DCP) profile (which focuses on care planning for patients).

Timelines

Initial content draft is already in place, planning to have everything finalized by July 21st for review by the sponsoring work groups.

When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org